ANGIOGENIC FACTORS IN MOYAMOYA DISEASE

Background and Purpose We previously reported that the level of basic fibroblast growth factor (bFGF) is high in cerebrospinal fluid (CSF) t aken from patients with moyamoya disease. The present study investigat ed the levels of other angiogenic growth factors in the CSF of moyamoy a patients and the clinical significance of bFGF in moyamoya disease. Methods The levels of bFGF, interleukin-8, platelet-derived growth fac tor, transforming growth factor-beta, endothelial growth factor, and v ascular endothelial cell growth factor in CSF, taken from 38 patients with moyamoya disease and 16 patients with atherosclerotic occlusive d isease (control group), were measured by an enzyme-linked immunosorben t assay. We analyzed the correlation between the level of bFGF and the clinical factors of age, onset pattern, development of neovasculariza tion, and cerebral circulation. Results The CSF of moyamoya patients c ontained a high concentration of bFGF to a significant (P<.05) extent. The bFGF level was apparently elevated in the patients in whom neovas cularization from indirect revascularization, such as encephaloduroart eriosynangiosis, was well developed (P<.01). A linear correlation betw een the values of bFGF and cerebral vascular response to acetazolamide (r=.7; P<.05) was revealed. The other angiogenic factors were not sig nificantly high compared with the control group. Conclusions The eleva tion of bFGF in moyamoya disease seems to be specific and is not relat ed simply to cerebral ischemia. Clinically, the bFGF level is a useful indicator to predict the efficacy of indirect revascularization after surgery.